Dean Smith


May 2010

Document Type


Degree Name



Dept. of Medical Informatics and Clinical Epidemiology


Oregon Health & Science University


The story of Health Information Technology (IT) interoperability can be compared to the proverbial Tower of Babel, wherein all people originally spoke one language. The medical record, historically a paper document used to record health care data, was interoperable within the confines of technology. It could be written, mailed, copied, faxed, even more recently, scanned and sent as an email attachment. However, as electronic health IT systems have evolved and proliferated with their own unique framework, they have become increasingly isolated and non-interoperable. This review examines the fundamental requirements for and global implications of health IT interoperability. Lack of system interoperability is a significant barrier to the implementation of health IT globally. This prevents health IT from fully realizing its potential as a tool to improve overall healthcare quality and medical research, increase surveillance for pandemics and other public health concerns, and from serving as a ‘rising tide’ that raises the level of health systems worldwide. On a more pragmatic level, lack of global health IT interoperability has significant impact on all who travel, work, and live abroad. This paper is based on a review of the recent literature regarding health IT interoperability. It explores the present status of specific nations to implement interoperable solutions within their existing health IT systems. The benefits of interoperability are examined in depth, along with the many barriers that stand in the way. Finally, solutions to these barriers are reviewed, as are the requirements for implementation. These solutions are crucial for health IT to deliver the many societal benefits it promises to bring to global health.




School of Medicine



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